UK Centre for Tobacco and Alcohol Studies

Sheffield

We are delighted to announce that UKCTAS has been successful in securing future funding through a multi-funder research initiative; the UK Prevention Research Partnership (UKPRP). UKTCAS academics joined forces with new collaborators and a range of public and private sector organisations to apply to the UKPRP.

The new consortium has now been awarded £5.9 million funding over five years and is called SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM).

UKPRP research grants aim to develop, test and refine new, practical and cost-effective approaches to preventing non-communicable diseases at scale, which will in turn help to reduce health inequalities across the UK. The initiative is supported by twelve funders from UK Research and Innovation research councils, charities and government. In its first round of funding, four Consortia and four network grants have been awarded.

Prof. Linda Bauld, University of Edinburgh

“SPECTRUM intends to address some of the most controversial questions facing the health of our population. To reduce diseases like cancer, heart disease, diabetes and respiratory diseases we need to address their main preventable causes. To do so means introducing and enforcing public health policies that often clash with the business interests of very profitable companies.

SPECTRUM aims to produce research that can rise to this challenge. This research will be used by our partners outside of academia, who will be active members of SPECTRUM, to make the case for effective policy and practice to improve health and address inequalities in the UK and further afield.”

The SPECTRUM Consortium is led by Professor Linda Bauld (pictured above) from the University of Edinburgh and for the last 10 years has been the deputy director of UKCTAS. Co-investigators and collaborators from 10 Universities in the UK and one in Australia are included. In addition, the Consortium brings together leading alliances that aim to improve health and reduce inequalities in the UK and further afield, along with Public Health England, Health Scotland, Public Health Wales and two independent companies specialising in statistical modelling and retail data.

SPECTRUM will aim to conduct research to prevent and address harm to health from unhealthy commodities by using systems science to identify and evaluate solutions. The focus of the new Consortium will be the commercial determinants of health and health inequalities, continuing UKCTAS’s work at the population level on tobacco and alcohol, but also extending to unhealthy food and drink products where appropriate. The research will be organised around 8 inter-related Work Packages involving new research, along with knowledge exchange, impact and public engagement activities.

New research published in Addiction, conducted by researchers from the Universities of Liverpool and Sheffield, highlights the potential benefits of reducing the standard serving size of alcoholic beverages.

It is well known that alcohol consumption contributes to premature death and ill health, and alcohol-related harm places a substantial burden on society. Many drinkers find it hard to cut down and attempts to cut down often do not lead to actual reductions in alcohol consumption. Therefore, changes to the environment that make it easier for people to drink less could have a substantial impact on public health.

One potential environmental influence on alcohol consumption is serving size. Nutrition research consistently shows that portion sizes affect how much a person eats. People eat more if they are given a relatively large portion of food compared to smaller portions, but they do not compensate for this by eating less later on. However, the effect that serving size has on alcohol consumption has not been examined until now. The present research aimed to investigate if reducing the serving size of alcoholic beverages would reduce alcohol consumption.

Standard vs Reduced serving sizes:

The researchers, led by Dr Inge Kersbergen from the University of Liverpool, tested the effects of reducing the serving size of alcohol on how much alcohol participants drank in two studies.

In the first study, participants were randomized to consume alcohol from standard or reduced serving sizes whilst watching a one-hour TV programme in a laboratory that looks like a living room. Standard serving sizes contained 2.07 units per serving (equivalent to a pint of weak lager) and reduced serving sizes contained 25% less than the standard serving.

In the second study, participants were invited to one of four pub quiz nights in a local bar which only sold standard vs. reduced serving sizes. Standard servings were pints and 175ml of wine (‘typically served as a medium glass in pubs’) and reduced servings were 2/3 pints and 125ml of wine (‘small glass’). Drink prices were adjusted to make sure that the standard and reduced serving sizes were the same value for money. Researchers observed how much alcohol each participant drank.

In both experiments, participants could order as many drinks as they wanted for the duration of the experiment. This means that participants drinking from reduced servings could compensate for the smaller serving size by ordering more drinks if they wanted to.

The researchers found that participants who were served relatively smaller servings drank less alcohol in a single drinking session than participants who were served standard servings. In the first study, reduced serving sizes led to a 20.7% – 22.3% decrease in alcohol consumption over a one-hour drinking period in the ‘living room’ lab. In the second study, reduced serving sizes led to a 32.4% – 39.6% decrease alcohol consumption over a longer drinking period (up to three hours) during the real-life pub quiz.

Based on the results the researchers used the Sheffield Alcohol Policy Model to estimate that reducing the standard serving size of beer, wine and cider in bars and restaurants by a quarter would lead to 1,400 fewer deaths and 73,000 fewer hospital admissions every year.

Public health intervention:

Dr Kersbergen, said: “These studies are the first to demonstrate that reducing the serving size of alcoholic beverages prompts reductions in alcohol consumption.

The typical serving size of beer in the UK of a pint is larger than many other countries and the size of wine servings in UK bars and restaurants has increased in recent decades, so there is room for serving sizes to be reduced without making them unrealistically small. Reducing the standard serving size of alcohol in bars and restaurants may be an effective way to reduce alcohol consumption at the population level and improve public health.”

Professor Matt Field, who leads the Addiction research group within the Department of Psychological Sciences at the University of Liverpool, added: “Reducing the standard serving size of alcoholic drinks could automatically prompt people to drink less, even if they are not motivated to cut down. But at the same time, the total amount that people consume would remain completely their own choice”.

Dr Eric Robinson, a University of Liverpool researcher who was also involved in the study, said: “Our research showed that people do not seem to compensate for the smaller servings by ordering more drinks on a single night and it seems unlikely that any further compensation would happen, but future research is needed to find out if people may compensate in other ways, such as drinking more often or getting stronger drinks.”

The full study, entitled ‘Reducing the standard serving size of alcoholic beverages prompts reductions in alcohol consumption’, can be found here and was funded in part by an MRC research grant awarded to Dr Eric Robinson.

Following the successful Alcohol CPD courses held in 2014-2017; we are delighted to announce the line-up for our 2018 course, featuring some exciting new inputs!

This year’s course will feature inputs from Prof. Anna Gilmore and colleagues from the University of Bath, Dr Carol Emslie from Glasgow Caledonian University, Dr James Nicholls from Alcohol Research UK, and Professor Karine Gallopel-Morvan from the EHESP School of Public Health, France. We also welcome the return of highly-rated inputs from leading experts such as Katherine Brown from the Institute of Alcohol Studies and Colin Shevills of Balance North East.

What previous participants said:

“Great range of content and world-class speakers. Organisers did an amazing job including looking after us all while we were here. The mix of lectures / Q & As / panel discussions was great. Really worth taking time away from work/home to attend this.” “Extremely informative course and relevant to current alcohol policy challenges. Good venue, convenient location and lovely setting. Module well organised and brilliant range of speakers.” “Thank you very much. It was a great privilege to listen and attend this course. Lectures and lecturers were outstanding.” “Very informative useful training, well worth my time and travel.” “Wonderful networking opportunity.” “Thank you for such a brilliant training event – the content was spot on, all the presentations and sessions were really, really good and I came away feeling that I had learned masses: a rich diet of fact and opinion. I can honestly say that I have rarely – if ever – enjoyed such an event quite as much as this one.”

Anyone wishing to gain an in-depth understanding and up to date insight into evidence and innovative practice in alcohol policy in the UK and internationally.

Previous participants have included people working in public health, local and national alcohol policy, or alcohol research; from Iceland to New Zealand.

Places are filling up fast and the early-bird rate applies until Friday 15th June 2018!

It’s been a long road but doctors and health experts are finally welcoming a minimum unit price for alcohol as the pioneering law comes into force in Scotland. The new 50p floor price aims to tackle Scotland’s unhealthy relationship with drink by raising the cost of cheap, ­high-strength products.

The Scottish ­Government warned retailers they will have no grace period to alter prices and shops will be targeted for spot checks.

Minimum pricing was delayed for a decade by opposition MSPs and a legal ­challenge led by the Scotch Whisky ­Association. Holyrood opponents eventually changed their minds and the Supreme Court upheld the ­legislation last November.

If your drink of choice is already being sold for more than the minimum price, then it will likely remain unchanged. But if it is currently being sold for less than the minimum price, you can expect the cost to rise to at least the minimum level.

For example, if a 9.8 unit bottle of wine is currently being sold for £3.50 in your local supermarket, it will set you back at least £4.90.

Dr Peter Bennie, chairman of the British Medical Association in Scotland, said:

“It has been a long road but I am delighted that the ­persistence of alcohol campaigners, with strong BMA support, has paid off and minimum pricing has finally taken effect.

Minimum unit pricing is a policy that will help to save lives and reduce alcohol harms in ­Scotland. It will help to reduce the burden of alcohol on our health service, on society, and most ­importantly on ­individuals and their families.

This is an important milestone for Scotland. Other parts of the world will now be watching the implementation with great interest.”

Bennie said the alcohol industry discovered it cannot expect to block ­policies designed to protect health.

“Alcohol causes 1100 cases of cancer every year in ­Scotland. The less alcohol you drink, the lower your risk of cancer. A minimum unit price is one action among many that will help reduce how much alcohol is consumed in ­Scotland.”

Professor Linda Bauld, Deputy Director of UKCTAS

The law only covers Scotland, leading to ­loopholes for online purchases. Guidance last month stated that supermarket meal deals where wine is included are unlikely to be affected. Retailers are also advised that “click-and-collect” purchases won’t be covered by the law if cheap drinks are first sent from outside Scotland. Customers can buy over the internet or by phone from a business in England. A delivery firm down south would be allowed to send drink to customers in Scotland.

“I am proud the eyes of the world will once again be on Scotland with the introduction of this legislation.”

“Scotland has the highest rate of alcohol-related deaths in the UK. I hope we will see that change.”

Health Secretary Shona Robison

12 years apart but arguably the most important measures to improve population health introduced in Scotland for decades. MUP will be robustly evaluated, as was smokefree legislation in Scotland. As with smokefree, the results should provide evidence of international importance. pic.twitter.com/ZAVnB3cFBz

Fact! Minimum unit pricing only impacts the cheapest, strongest products sold in supermarkets and shops. Drinks in pubs and restaurants are already priced over 50p a unit so will be untouched. #MUPsaveslives

Three quarters of all alcohol consumed in Wales is drunk by less than a quarter of the adult population who are hazardous or harmful drinkers and spend up to £2,882 per year on booze, research has revealed.

A report looking into the potential impact of minimum unit pricing and taxation policies in Wales was published Thursday 22nd February by the Sheffield Alcohol Research Group at the University of Sheffield.

The publication, which found that the 3% of the population who are harmful drinkers, account for 27% of all alcohol consumed, comes after the Welsh Government announced a new Bill that, if agreed by the National Assembly, will introduce a minimum price for the sale of alcohol.

The Bill, which is designed to reduce hazardous and harmful drinking would make it an offence for alcohol to be supplied below that price.

“The introduction of a minimum unit price would be effective in reducing alcohol consumption among these groups, as well as reducing the number of alcohol-related deaths and hospitalisations.”

The availability of cheap, strong alcohol is estimated to lead to 50,000 alcohol-related hospital admissions a year, costing the Welsh NHS £120 million annually and, in 2015, there were 463 alcohol-related deaths in Wales.

The report reveals the population of Wales buys 50% of its alcohol for less than 55p per unit, 37% for less than 50p per unit and 27% for less than 45p per unit, with heavier drinkers being more likely to buy alcohol sold below these thresholds.

Mr Gething said: “The report shows the greatest impact of a minimum unit price would be on the most deprived harmful drinkers, while moderate drinkers would experience only small impacts on their alcohol consumption and spending.

“This is because moderate drinkers tend to buy alcohol which would be subject to little or no increase in price under the policy.

“If passed, this law will potentially save lives.”

The research also shows harmful drinkers spend an average £2,882 a year on alcohol, or around £7.80 per day, compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.

The Sheffield Alcohol Research Group, commissioned by the Welsh Government in June 2017 to update a 2014 appraisal of the likely impact of a range of minimum unit pricing policies, concluded a minimum unit price set at between 35p and 70p would be effective in reducing alcohol consumption among hazardous and, particularly, harmful drinkers.

Research highlights:

Moderate drinkers drink an average of 211 units of alcohol per year compared to 1,236 for hazardous drinkers and 3,924 for harmful drinkers.

Harmful drinkers spend an average £2,882 a year on alcohol compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.

Alcohol-attributable deaths and hospital admissions are concentrated in hazardous and particularly harmful drinkers who are more deprived.

In a landmark ruling, seven justices unanimously rejected a challenge led by the Scotch Whisky Association that Scottish proposals for strict price controls were illegal under EU trade rules. The ruling comes after a five-year legal battle against the measures, which were passed by the Scottish parliament in 2012 but then fought by the Scotch Whiskey Association and two European wine and spirits industry bodies all the way to the European court of justice.

Nicola Sturgeon, Scotland’s first minister, first suggested the measure nine years ago while acting as the Scottish health secretary. The supreme court ruled on Wednesday 15th November that “minimum pricing is a proportionate means of achieving a legitimate aim”.

Prof Petra Meier, director of the alcohol research group at the University of Sheffield, which published the data and evidence that Sturgeon’s proposals were based on, said a 50p minimum price would in time result in 120 fewer deaths and 2,000 fewer hospital admissions from alcohol abuse each year.

“Our research has consistently shown that minimum unit pricing would reduce alcohol-related health problems in Scotland by targeting the cheap, high-strength alcohol consumed by the heaviest and highest-risk drinkers. Moderate drinkers would be affected to a much smaller degree.”

They said protecting public health outweighed the damage to free trade which the spirits industry and EU wine producers said they wanted to protect. “The courts should not second-guess the value which a domestic legislator puts on health,” the judges stated.

With Welsh ministers and the Republic of Ireland introducing similar measures, health campaigners in England said the ruling left the Westminster government isolated, and removed the last legal barrier to minimum pricing.

“We are delighted with the Supreme Court’s judgement that minimum unit pricing is legal and can be implemented in Scotland. The decision today represents a great victory for the health of the public.

“Five years ago the legislation introducing MUP passed through the Scottish Parliament without opposition. It has taken five years to implement for the simple reason that the Scottish Whisky Association and others chose to challenge it in the courts. In that time many families have needlessly suffered the pain and heartache of losing a loved one.

“This decision has implications far beyond Scotland. Wales, Northern Ireland and the Republic of Ireland are now clear to progress their own plans for minimum unit pricing.

“The spotlight should now fall on England, where cheap alcohol is also causing considerable damage. Over 23,000 people in England die every year from alcohol-related causes, many of them coming from the poorest and most vulnerable sections of society. We urge the Westminster Government to act now and introduce the measure in England. A failure to do so will needlessly cost more lives.”

Scottish ministers are expected to introduce a minimum price of 50p a unit for alcoholic drinks by spring next year, in a bid to cope with increasing deaths and hospitalisations from alcohol abuse. Health campaigners say the strongest but cheapest ciders were so cheap in Scotland an adult could consume their maximum recommended weekly limit of alcohol – 14 units – for £2.52. The cheapest fortified wine came in at 27p per unit, while the cheapest vodka and gin was 38p. That rate will force up the price of all alcoholic drinks so that a standard bottle of whisky will cost £14, regardless of its wholesale cost, although the Scottish measures mean retailers will keep any surplus profits once prices rise.

The Welsh government has said it would press ahead with proposals it published last month to implement minimum pricing, with Welsh ministers also evaluating a 50p minimum price. Ministers in Northern Ireland have also backed the policy, but implementation has stalled after the collapse earlier this year of Stormont’s power-sharing administration. The Republic of Ireland is also considering similar measures.

The Alcohol Health Alliance UK, which includes the British Medical Association and the Royal College of GPs, is drafting a joint letter to the UK government formally urging ministers to reinstate plans for similar measures in England.

Urged on by the medical profession and some police commissioners, the UK government came close to following Scotland’s lead while David Cameron was prime minister, but after disputes in cabinet the proposal was dropped. The Home Office, which takes the lead on alcohol control policy, said it noted the supreme court’s ruling but said it would only keep the issue under review. A spokeswoman said ministers in London would watch its implementation in Scotland, but Home Office officials were unable to specify how long ministers would wait before reaching a decision.

The department said its focus now was on using other measures to control excessive alcohol consumption, including higher duties for high-strength ciders, and lower duty for lower strength wines. There were campaigns and initiatives by NHS England to support problem drinkers. The SWA acknowledged defeat, and said it would help ministers implement the strategy. But it warned that imposing strict price controls would increase the risk of other countries using the policy as justification for higher tariffs on Scotch whisky imports, damaging its £5bn-a-year export trade.

The brewing trade was split: major brewers, such as the makers of Tennents lager and Magners cider, with higher cost brands and a significant stake in supplying pubs, welcomed the court’s decision. The real-ale campaign group Camra denounced it, saying it “penalises moderate and responsible drinkers while doing little to support those who have issues with alcohol abuse”.

“The opponents to MUP have shamed the reputation of their industry by prioritising profits over people’s lives. As MUP has been delayed, we have seen the tragic, premature deaths of 24 people every week in Scotland as a result of alcohol misuse, many of them in our poorest communities, and affecting families across our nation,” he said.

Twitter posts about the decision:

Absolutely delighted that minimum pricing has been upheld by the Supreme Court. This has been a long road – and no doubt the policy will continue to have its critics – but it is a bold and necessary move to improve public health.

MUP IS LEGAL says UK Supreme Court. Victory for public health but 5 year delay due to @ScotchWhiskySWA litigation has cost dearly. Now for rest of UK to follow plus @ScotGov implementation, evaluation and package of other policy innovation to address marketing and availability.

Alcohol consumption will cause 63,000 deaths in England over the next five years according to a new report from the University of Sheffield Alcohol Research Group.

The report, published by the Foundation for Liver Research, predicts that 32,475 of the deaths – the equivalent of 35 a day – will be the result of liver cancer and another 22,519 from alcoholic liver disease.

In its new report, Financial case for action on liver disease, endorsed by the independent Lancet Commission on Liver Disease, the Foundation for Liver Research urges the Government to implement a suite of policy measures designed to mitigate the rising health and financial burden of alcohol, including the introduction of minimum unit pricing (MUP), re-institution of alcohol duty escalator and advertising restrictions.

Between 2017 and 2022 the total cost to the NHS of alcohol-related illness and deaths will be £17 billion.

Providing evidence in support of Government intervention, new modelling shows that within five years of its introduction in England, a 50p MUP alone would result in:

1,150 fewer alcohol-related deaths

74,500 fewer alcohol-related hospital admissions

Savings of £325.7m in healthcare costs

Savings of £710.9m in crime costs

The total financial savings to the public purse of MUP is forecast to be £1.1 billion – the equivalent cost of the Government’s recently announced investment package for Northern Ireland.

Colin Angus, Research Fellow at the University of Sheffield and part of the Sheffield Alcohol Research Group who conducted the research, said:

“These new findings show there will be 35 deaths and 2,300 hospital admissions due to alcohol every day in England over the next five years. We estimate this will cost the NHS £17 billion at a time when healthcare resources are already overstretched. Our research also shows that policies such as Minimum Unit Pricing have the potential to significantly reduce this burden.”

Liver disease is one of Britain’s biggest killers, claiming about 12,000 lives a year in England alone. The number of deaths associated with it has risen by 400% since 1970. It is estimated that 62,000 years of working life are lost every year as a result of it. People who develop serious liver problems also suffer some of the worst health outcomes in western Europe.